Hospitable Hospitals and the True Cost of VIP Rooms

By Vadim Shteyler

Increasing hospitality in medical facilities is not a recent trend. We take for granted that modern hospitals offer clean sheets, towels, a plethora of toiletries, heated blankets, and many other amenities. Conversely, in the hospitals of decades past, many patients relied on family members to bring food and clean sheets. Rows of hospital beds in an open ward precluded privacy. Unhygienic conditions commonly resulted in rodent infestations. And paternalism in medicine was still the norm.

This trend towards hospitality has recently gained new momentum. As featured in a recent article in Kaiser Health News, dozens of hospitals have hired Chief Patient Experience Officers from customer service or hotel industries. Since 2012, when Medicare began penalizing hospitals for poor patient experiences, hospital efforts to improve patient satisfaction have grown. Some hospitals began mandating communication seminars, encouraging nurses to spend more face-to-face time with patients, and calling patients after discharge to follow-up on their recovery. The Affordable Care Act (ACA), further tying hospital reimbursements to patient surveys, has additionally promoted such changes.

A similar trend has arisen with the increased popularity of V.I.P. sections in many hospitals. Though the hospital construction boom is beginning to slow down, the resultant V.I.P. rooms remain. Lenox-Hill Hospital’s maternity suite in New York City, which received a lot of media attention after Beyonce gave birth there in 2012, is one of many luxurious suites across the nation. Some, offering personal shoppers, private chefs, and salon services, are priced upwards of $4,000. While nobody calls for a return to the hospitals of old, many feel suites such as these are excessive. 

Increased hospitality in hospitals serves to benefit patients in ways beyond their general satisfaction.  When patients see that healthcare providers are attentive to their needs, they are more likely to trust their providers, actively participate in their own care, adhere to treatments, and return for care if they need it.

V.I.P. floors have been criticized for accenting a hospital’s business goals, increasing disparities in an institution that should be making resources equally available to all, and, as in the case of Beyonce, inconveniencing so many neighboring non-V.I.P. patients (read more here). Arguably, V.I.P. floors also serve to empower patients and provide comforts and services that may ensure that patients return for care if they need it. However, besides the described social harms, some doctors worry that V.I.P. floors may actually harm V.I.P patients.

It is difficult to treat a V.I.P. patient the same as any other patient. When a hospital treats a patient differently, the patient-doctor relationship is affected as well. In many ways, doctors provide a service like many others, they aim to alleviate patients’ discomforts and cater to their needs. However, doctors also offer expert opinions and recommendations. When all patients feel more empowered, quality of care is generally improved. In contrast, when few patients feel privileged, they do not only expect better care but they may also expect unrealistic outcomes. By a provider’s report, even non-V.I.P. patients who stay in V.I.P. rooms (due to hospital bed shortages) experience a shift in expectations. It is almost as if an unfavorable outcome, even when attributable to advanced disease or the uncertainty of medicine, becomes an example of subpar service.

Certain hospitals handpick the physicians they believe would treat a V.I.P. patient most expertly. One physician expressed concern about the way the increased confidence of being chosen can negatively impact patient care, even when those harms are not measurable.

Another concern about V.I.P. floors, expressed by a doctor in this New York Times article, is that they tend to be more secluded from the other wards. Consequently, cardiac arrest teams were not able to get to V.I.P. floors as quickly as to regular floors.

The many differences in the way hospitals treat V.I.P. patients undoubtedly leads to many differences in the way doctors relate to them. Though many of these differences may be positive for the patients, this post explores a few ways in which devoted V.I.P. floors may actually harm V.I.P. patients. With so many resources spent on these rooms, it is worth further exploring their true value. It may be the case that increasing hospitality only benefits anyone when it is available to everyone.

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